Non-insulin-dependent diabetes mellitus is one chronic health problem underscoring the disparity in health between American Indians and European Americans. The prevalence of diabetes among the Navajo tribe is four times greater than the age-adjusted U.S. population rate estimate. Clinical interventions that are most likely to succeed are those based on knowledge of salient cultural values, historical context and socialization processes that shape personal understandings of illness. The failure to understand and integrate constructs about meanings of health and illness into treatment modalities often renders biomedical solutions irrelevant. Since it is not well understood how Navajos conceptualize diabetes, the goal of this critical ethnographic study is to hear the voice of the Navajo and to understand how Navajos socially construct diabetes. The aims of this study are to: 1) Identify and understand the conceptual meanings that Navajo Indians attribute to diabetes, 2) Describe relevant themes from individual accounts that may suggest a shared cultural understanding of diabetes by the Navajo, 3) Analyze how Navajos perceive current Western biomedical diabetic management techniques, and 4) Identify products of historical change and domination that appear to influence how Navajos speak about diabetes. Participant observation and interview techniques will be used to accomplish these aims. Study findings will contribute to the advancement of transcultural nursing theory development by providing population-specific illness meanings. These meanings may be utilized to support the design of more effective interventions to address diabetes for Navajo people. Furthermore, results from the study will highlight macrosocial issues related to diabetes that are relevant to the lives of Navajo Indians.